Provider Demographics
NPI:1982631974
Name:RAJAMANI, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RAJAMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611
Mailing Address - Country:US
Mailing Address - Phone:585-235-0360
Mailing Address - Fax:585-235-1617
Practice Address - Street 1:819 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611
Practice Address - Country:US
Practice Address - Phone:585-235-0360
Practice Address - Fax:585-235-1617
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185853207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01253387Medicaid
NYBB5887-GRP:70008AMedicare PIN
NY01253387Medicaid
NYBB5887-GRP:70008AMedicare PIN